THE enduring image of Florence Nightingale gliding through hospital wards in Scutari during the Crimean War bearing a lighted lamp and wearing a saintly smile has, in the view of some nurses, paved the way for what seems set to be the State's first national nursing strike.
They say the woman who is hailed as the founder of modern nursing encouraged the view of nurses as members of a largely passive workforce, one that was willing to settle for less than its due because of what was reverently referred to as its "vocation".
Fiona Edwards, a 27-year-old nurse working in Beaumont Hospital in Dublin, is critical of what she dubs the Florence Nightingale Syndrome. She is a member of SIPTU, one of four unions in the Nursing Alliance that rejected the £50 million pay deal offered by the Government last May.
But because she has worked in nursing for under nine years, the deal, had it been accepted, would have had no effect on her salary.
"I hate that term `vocation'. It makes us sound as if we are nuns. I am constantly amazed at how far the public perception of our jobs is from what we actually do," she says.
Nurse Edwards was recently promoted from staff nurse to acting ward sister but, despite the increased responsibility, she is now £100 a month worse off. It is because of this and other inequities she has observed within the system that she has become "frustrated and annoyed".
"Nursing is a career. It's a profession," she says. "We are a highly specialised group responsible for everything from direct patient care to education and administration. Young nurses are coming in and training but getting disillusioned because there are no incentives for them further down the line.
"There is only so much motivation you can give to yourself. You need someone to come along and say, `Yes, we recognise your contribution. Yes, we will give you adequate remuneration'," she says.
Donnchadh Whelan (28) is qualified in both psychiatric and general nursing but says that others with dual qualifications in paediatrics, midwifery and mental illness do not have this reflected in their salaries. He blames the hierarchical way hospitals have been run for an unwillingness among nurses to speak out.
"Nuns wore veils, so did the nurses. Nuns had a calling, nurses were viewed as having one, too. The nurses' confidence in themselves and their own ability appears to have strengthened as their roles widened and the religious ethos of hospitals decreased," he says.
Those in the older age bracket such as Mary Grogan, a 59-year-old staff nurse in Beaumont, were set to benefit under the Programme for Competitiveness and Work pay proposals by approximately £3,000 per year. But, she says, this is "no time to be selfish".
She says she is "delighted" with the stand nurses are taking now.
"When I went into nursing we were involved in the most menial of tasks. There was strict discipline. The matron was a figure of fear and we thought ourselves privileged to be in the hospital at all. When I joined in the 1960s my father actually paid a fee to get me into the service," she says.
"Now the nurse has so many extended roles that they are realising their worth and asserting themselves in a way that, because of the possibility of negative repercussions, would have been impossible before."
This new-found assertiveness, which seems to have been seriously underestimated by both union leaders and the Government, has manifested itself most within the traditionally conservative ranks of the Irish Nurses' Organisation (INO).
"We have got to the stage where enough is enough," says INO member Elizabeth Logan, the sister in charge at the intensive care unit in Beaumont Hospital. At regular intervals throughout her 20-year nursing career she has undergone training, like the majority of nurses, on her own time and at her own expense.
"At this stage I have done courses in management, administration, counselling, economics, midwifery and biology," she says. "Other professionals receive financial awards when they undergo training. Our basic salary remains unchanged."
Some feel the nurses are speaking out now because of the increased involvement of women in the unions. Des Kavanagh, general secretary of the Psychiatric Nurses Association (PNA), says nurses are stronger because "they now have an increased capacity to become involved and make their voice heard".
"The PNA has traditionally been more militant," points out Mary Craven, a psychiatric nurse working in rehabilitation. The PNA has already been on strike twice, winning vital concessions on each occasion. "At one time we had a predominantly male membership and unfortunately men have tended to be more outspoken about these things," she says.
Her colleague Catherine McTiernan, an assistant chief nursing officer at St Ita's Hospital in Portrane, Co Dublin, argues that the greatest objections are coming from nurses in the 40-50 age bracket.
"These women are experiencing a social environment that they never envisaged when they were teenagers. In their day you went into nursing for life, now due to better pay and conditions in countries like America and Australia, today's nurses are joining to travel the world" she says.
Despite working with her strike committee to ensure there will be a team of unpaid nurses providing the vital emergency services during the strike, Fiona Edwards has managed to keep her sense of humour.
"Some have suggested that we are being too materialistic in our demands," she says. "They would do well to remember that even Florence Nightingale had to pay bills."
